As an introduction, I am 32 year-old male who has been suffering with acne and extremely oily skin since my early teenage years. My acne is usually in the form of around 5-10 pustule/whiteheads at any given time, with the occasional cyst/nodule thrown in for fun about 1-2/month.

Over the past 20 years, I have tried literally everything on the market to combat my awful skin with primarily disappointing results. The only thing that has ever helped is the full course of accutane I took back in 2006. Not only did it clear my skin for over 2 years post-treatment, but it also kept me oil-free for nearly 9 months as well. Thus, I have am undergoing a second course of accutane to try to eliminate the oil and acne long-term. This time, however, I plan to take a much smaller dose and spread it out of the course of several years.

The brand of accutane I am using is ro-accutane manufactured by Roche. My original plan was to take 10 mg/day till the oil production stopped and then drop the dosage to find the minimum amount that will control the oil. I am currenly in my 5th week of this experiment and I have summarized the first month of this experiment below:

Week 1: Not much change occurred the first few days.However, about mid-week, 3 rather large, red whiteheads appeared on my right check. They continued to grow throughout the week. No change was observed in oil production.

Week 2: The 3 zits on my right cheek grew until they each had huge heads the size of pencil erasers. I treated them nightly with 10% BP. By the mid part of the week they heads dried up and became very hard while the body of the pimples began to gradually disapperf. By the end of the week the dried heads scabbed off, leaving behind slightly indented scars. Not cool! However, other than a couple of fresh scars, my skin looked better than it had in as long as I could remember.

Week 3: Two of the spots I had left week definitely left indentations Other than that, my skin definitely looked great for the entire week. I began to notice some slight drying of my lips in Week 2, which only increased this week. Still oily, but there might be some slight improvement in the area too. Hard to tell.

Week 4: Ugh, my brief vacation of decent skin came to an abrupt halt! A huge puss-filled monster literally grew on my right cheek overnight. Looks like red, inflamed marble half way embedded on my check. Have another huge cyst develop on my other side as well. Luckily it is so deep that it's only slightly noticeable at this point. Definitely a rough work week dealing with these things on my face. I was so embarrassed to deal with clients! My skin seemed to be just as oily as ever. With the huge cysts developing and my skin remaining a bright, shining mess, I decided to bump the dosage up to 20mg/day to speed up the results.

the dreaded initial breakout, ugh....if the full course worked in 2006, why not do that again? And just be careful with the higher doses, you really should be doing bloodwork- I take it you are self medicating?

I'm not sure if what I'm experiencing right now is my IB or not? When I took a full course several years ago, my IB was undeniable because it was the worst breakout I had experienced up to that time and even since. Whether it is or not, however, these two cysts are pretty bad and have me worried about further scarring.

As for why I'm not taking a full course, A.) I am uninsured at the moment and accutane/monthly doctor appointments are super expensive; and B.) I want to extend my treatment time to have the longest vacation from oily skin possible. However, I haven't ruled out increasing the dose and just completing a "normal" course. If I come up with money to treat my preexisting scarring, then I will be tempted to do just that, so I can have it done ASAP.

Finally, to answer your last question, yes I am, but I'm being as careful as possible. It might sound crazy to you, but I am done living with this condition and am ready to move on with my life. Accutane is the only thing that has ever helped me, unfortunately.

Update: Well as shortly after I last posted, the large zit on my Right side ruptured in the shower. Puss and blood was everywhere. It has been shrinking rapidly the last couple of days, but Im afraid it will leave a scar. Overall though, my skin looks pretty good right now besides all my scarring.

It's been 5 and half weeks now. IThe large zits I last posted about are slowly disappearing and I have not had any new ones appear. That has me pretty stoked!

Unfortunately though, I'm still freaking oily! In fact, the only symptoms I've noticed is mildly dry lips. To say the least, I'm pretty disappointed by the lack of progress and am worried that only 10 mg/day might not be enough achieve my goal of not having an oil slick sitting on my face all day.

Anyway, if you anyone is even reading this, I will try to update again in another week.

Week 6: Not much has changed. I'm still oily which sucks. I had a few minor pimples this week, but they all disappeared pretty quickly. I'm going to continue using 10mg/day although I'm starting to get concerned that it's not going to be enough to stop the oil.

It's been almost 3 months since I started taking 10mg/day. Unfortunately, I'm still kinda oily, so I haven't been able to taper off the accutane. Also, since starting I've had a several large nasty zits that have each left indented/red scars behind. Kinda disappointing, but i had the same thing happen when I took a full course years ago.

Things aren't all gloomy, however. At this moment I really don't have much active acne on my face. Likewise, although I'm still kinda oily, there seems to be a bit of improvement.

It's been almost 3 months since I started taking 10mg/day. Unfortunately, I'm still kinda oily, so I haven't been able to taper off the accutane. Also, since starting I've had a several large nasty zits that have each left indented/red scars behind. Kinda disappointing, but i had the same thing happen when I took a full course years ago.

Things aren't all gloomy, however. At this moment I really don't have much active acne on my face. Likewise, although I'm still kinda oily, there seems to be a bit of improvement.

Anyway, I will try to do a better job updating. Wish me luck.

Thanks for the update. How's it going now? How is your active acne and have you had any more of the large nasty zits? I am 40 days into low dose (3x20mg week) and every time I clear up for a few days I seem to break out again. I am hoping as my course progresses I will stay clear.

It's been almost 3 months since I started taking 10mg/day. Unfortunately, I'm still kinda oily, so I haven't been able to taper off the accutane. Also, since starting I've had a several large nasty zits that have each left indented/red scars behind. Kinda disappointing, but i had the same thing happen when I took a full course years ago.

Things aren't all gloomy, however. At this moment I really don't have much active acne on my face. Likewise, although I'm still kinda oily, there seems to be a bit of improvement.

Anyway, I will try to do a better job updating. Wish me luck.

Thanks for the update. How's it going now? How is your active acne and have you had any more of the large nasty zits? I am 40 days into low dose (3x20mg week) and every time I clear up for a few days I seem to break out again. I am hoping as my course progresses I will stay clear.

Overall, my acne situation has definitely improved since I started. I still get some a pimple here and there (had a gnarly one on my left cheek last week), but at this moment I have next to no active acne. My skin still gets somewhat oily, however, which really sucks.

How are you doing now? How's the last month been? Still no active acne?

Hope it's all going well for you!

Thanks for the well wishes. Sorry I haven't been checking Acne.org lately. When my acne is behaving, I tend to not visit as much

I'm still taking 10mg/day every day. I'm pretty clear with no real significant active acne. My face has never gotten super dry, but my crazy oil situation appears to be more in check than before I started this regime.

Thank you so much for this log, I really appreciate it and I'm sure a lot of peeps out there do too.

I am a 21 year old male from South Africa. I weigh 69 kg. I was on a 30mg/day dosage three years ago, skin cleared up and stayed beautiful for 6 months. I then went on a 20mg/day dosage last year but was not able to finish the cycle and it has not even been 4 months and my skin is starting to flare up again. My skin is not all that bad, but just went to the dermo today to play safe and here what my options are.

She said that I should go back on Accutane and I asked for a low dose. She said that i could go on a 10mg/day dosage for 23 months if I want to. After reading up on low-dosage treatment, I am scared that the results will be the same but that my chances of relapsing within a few months are bigger than someone on a high dosage.

I am not sure if I should rather go on a 40mg/day treatment and suffer but have better chance of having permanent clear skin than having to go on Accutane again after my 23 months had past and I break out again.

Any advice on this will be greatly appreciated! Good luck for everyone on treatment!

Thank you so much for this log, I really appreciate it and I'm sure a lot of peeps out there do too.

I am a 21 year old male from South Africa. I weigh 69 kg. I was on a 30mg/day dosage three years ago, skin cleared up and stayed beautiful for 6 months. I then went on a 20mg/day dosage last year but was not able to finish the cycle and it has not even been 4 months and my skin is starting to flare up again. My skin is not all that bad, but just went to the dermo today to play safe and here what my options are.

She said that I should go back on Accutane and I asked for a low dose. She said that i could go on a 10mg/day dosage for 23 months if I want to. After reading up on low-dosage treatment, I am scared that the results will be the same but that my chances of relapsing within a few months are bigger than someone on a high dosage.

I am not sure if I should rather go on a 40mg/day treatment and suffer but have better chance of having permanent clear skin than having to go on Accutane again after my 23 months had past and I break out again.

Any advice on this will be greatly appreciated! Good luck for everyone on treatment!

If it was me, I would do the 40mg/day. I had acne and it sucked, but I mainly started the 10mg/day regime to deal with my super oily skin.

As an update, I had a pretty nasty zit a couple of weeks ago, but other than that I've been clear. My skin still seems a oily though, so I'm not sure how well this tane is working.

I am taking 10mg every other day at the moment. Unfortunately, I don't think this has helped the oil much. It might be that my accutane is no good, or the doseage is too low. At least I haven't had much acne in months!